Tag: teleradiology

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Why Working From Hawaii Doesn’t Work For Most Of Us!

Hawaii

“The best laid plans of mice and men often go awry” is a famous quote that cannot be more true for us radiologists. I’m sure many of you have thought about what it would be like to work from a tropical island like Hawaii to read teleradiology cases several weeks out of the year in practice. Doesn’t sound too bad? How about reading evening studies and frolicking on the beaches with a Mai-Tai in hand in the daytime? Well, sorry to be the bearer of bad news; I will have to squash that thought for most of you. And here are some of the most likely reasons it won’t work.

It’s Still Relatively Easy To Hire Tele-radiologists

Although it is more expensive than a few years ago, if a practice has to choose between hiring overnight teleradiologists or a nighthawk and paying for a place in Hawaii for radiologists to read 6 hours every day, it is a lot less expensive to hire the overnight radiologist. Paying for a home for radiologists can be costly. And not everyone may want to go!

Not Everyone Can Get To Hawaii From Practice 

Believe it or not, if you create an outpost for radiologists to practice on a tropical island, not all of them can pack their bags and go. Some have families, and others have obligations that root these radiologists to the motherland. It is just not easy to get there for everyonee.

Additional IT Headaches

When creating a new outpost, you must ensure it runs well. The last thing a practice wants is a malfunctioning PACS system in a faraway outpost. That burden means the imaging business must pay for excellent IT support. And, with IT support comes additional expenses to maintain the site. Moreover, if the site goes down, other radiologists in the hometown will have to come to the hospital in the wee hours.

Billing Problems

Although not a complete game changer, with all the other issues, the location of dictations can create a headache for billing. Insurance companies do take into account the locale of the dictations. And this can make the process somewhat harder to get reimbursed. Let’s just add-on another issue to the whole!

Not Everyone Likes The Beach In Hawaii

Although going to Hawaii every once in a while to read some cases may sound great, not everyone loves the beach. Yet, your group will have to flip the bill for this privilege. Working from a beach location means you have to like crystal clear water and coconuts. What floats your boat may not be attractive to everyone!

Time Of Working May Not Be Optimal 

The time difference of 6 hours is not a reversed schedule. That means that when you go to bed at 10 PM EST, it is 4 PM in Hawaii. So, if you want coverage from 10 PM until 8 AM EST, you must go to work from 4 PM to 2 AM in Hawaii. Although better than working entirely overnight, it is not perfect for many radiologists. Some radiologists are early birds!

It Takes A Bit Of Extra Effort

Finally, creating another outpost outside your location takes some work and time. And most radiologists don’t want to have to deal with extra burdens. So, although it may be nice in theory, in practice, there are lots of other issues to worry about, first and foremost!

Nice Thought, But Hawaii Probably Will Not Happen In Your Practice!

Sorry to burst your bubble. I didn’t mean to put a kibosh on your hopes and dreams. Nevertheless, we need to be realistic. As you can see, all the headaches you need to work from Hawaii will probably not be worth the effort. Although a great idea, in theory, that’s another story in practice. If you like Hawaii, you may have to go there on vacation or work in Hawaii as your primary job!

 

 

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Coronavirus: A Clarion Call For Universal Home Teleradiology

coronavirus

OK. By now, you are probably somewhat sick of hearing about the coronavirus. But, the illness certainly brings up specific issues in radiology that should rise to the forefront. As a microcosm, within my practice, we are intensely discussing preparations for the coronavirus storm that has begun. Will the next patient be a coronavirus victim, and will she expose our radiologists? What will happen if some of our radiologists become sick and cannot perform our duties? Can we provide the services that our customers and the hospital expect?

Without definitive guidance on what to do next, we are currently debating the appropriate responses. But one thing is clear. In this environment, we need to have the ability to read cases from home. Teleradiology from home is no longer a luxury but rather a necessity.

Hospitals, residencies, and practices that do not provide teleradiology are at risk of giving poor health care to their patients. Therefore it is the responsibility of hospitals and large imaging centers to supply the resources necessary expeditiously for remote reading. And, we have discovered that teleradiology in an emergency helps the most to decrease exposure, increase radiologist efficiency, and increase the flexibility of the radiologist workforce. So, let’s talk about these issues specifically.

Reducing Radiologist Exposure

Sure, we will need to have someone on the premises to perform specific responsibilities like interventional treatments, radioactive iodine administrations, etc. However, do we need all our radiologists to be present? Probably not. Why increase the risks to employees and physicians when you can mitigate exposure to the coronavirus? In the case of coronavirus, you want to protect the elderly radiologists and those families with babies or the infirm elderly at home. The ability to perform teleradiology decreases the number of staff members on the frontline, especially those at most risk. Thereby, you will have fewer radiologists and families affected by the virus. And, it is not necessarily just the coronavirus. The same goes for any pandemic. Do you really need to increase the number of infected hospital workers/radiologists?

Increases Radiologist Efficiency

One of the side effects of a pandemic is a potentially large amount of patients that need imaging. How do you provide these services with a fixed number of radiologists available? Well, for one, teleradiology enables a group to increase the capacity of imaging reads throughout a system. It becomes easier to read additional studies when the need arises. With a workstation at home, you can pick up a case at almost any time to help out when needed. And, one never knows when the flood of imaging for a disease will start. A hospital nightmare scenario would be to have a large number of patients storming the emergency department without the capability to increase the number of reads during an emergency!

Increases Flexibility of The Workforce

When an epidemic strikes, some of the healthcare workers will inevitably become ill. And, radiologists are not immune. Especially with a disease like a coronavirus, most infected workers will have very mild symptoms. Why would you want to take them out of the workforce when they can read from home and help with the overwhelming increased burden of patients in the system. For others, it allows those with babies or school-age children at home to contribute as well. The last thing that the hospital needs is a shortage of radiologists during a time of need. Hospitals should be encouraging all able bodies to participate in a fully staffed department. Home teleradiology enables efficiency.

Coronavirus: A Call To Teleradiology Action

Sometimes you need a wake-up call to get you going. And, the coronavirus is doing just that. For practices without home teleradiology services (like ours), we need to mitigate exposure, increase efficiency, and augment flexibility for the best patient care. And, this pandemic has demanded that the hospital should be focusing their resources, so that home teleradiology is available to their radiologists. It’s the right thing to do.

 

 

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Should I Be An Independent Gun For Hire?

independent gun

Nowadays, new radiologists may face a new choice, not as prevalent years ago. As such, you may work for one or more than one firm that allows the option of independent contracts or employed work. Most commonly, this decision exists for those who choose teleradiology. But other arrangements are also possible. So, what do you do? Do you operate as an independent contractor getting yearly 1099 forms? Or do you take employment wages and receive a W-2 at the end of the year? Although this decision may seem innocuous, significant consequences await those who don’t think about how to proceed. So, today we will discuss the advantages and disadvantages of contracted work. In addition, we will talk about a significant pitfall you must avoid when you begin your first independent contractor job. Let’s start!

Reasons To Become A Gun For Hire

Independence allows radiologists to contract out with multiple groups. Many employed positions muzzle the worker by outlining in the contract that they may not work with other groups or outside work. On the other hand, theoretically, as an independent contractor, you can work with five or more different groups and facilities. Similarly, the more the independent contractor works, the more you can get paid. This workflow differs dramatically from an employed worker that often has a fixed salary with, perhaps, a small production bonus.

In addition to the ability to work with multiple facilities, the independent contractor can also deduct expenses from their income taxes. As a typically employed radiologist, you cannot write off items like fax machines, paper, health insurance, 401k plans, and more. When you work for yourself, all these deductions can significantly reduce your taxable income. Therefore, making more take-home income with the same salary is possible.

Then, of course, depending on how you structure your business, you may be able to take advantage of the new tax laws that favor corporations. For instance, you may depreciate capital equipment more rapidly over time. And, if your income dives below a lower threshold, you can deduct additional earnings as a pass-through corporation. Additionally, you may be able to put more retirement account funds away in a SEP-IRA versus an employed 401k plan. Whatever the case, I highly recommend discussing the consequences of different corporate structures and tax ramifications with your accountant.

Becoming A Gun Is Not All Peaches And Cream!

What issues do independent contractors need to contend with? Maintaining contracts with different entities becomes your responsibility if you independently contract with multiple facilities. And the loss of one or more contracts can devastate your finances if you rely on this income to sustain your household. No longer can you rely on your employer for your paycheck.

Working for yourself as an independent contractor can also become a lonely business. Instead of working in an extensive practice with many other radiologists, some independent work can isolate you from your colleagues. For some, this can be a potential deal breaker.

Other issues arise, such as traveling from facility to facility to work. (if you work at multiple locales) If you have a more capital-intensive business and, for instance, you run remote computer software, you may need to fix the equipment if it goes down. Or, if you work from home and have a power outage, how do you run your business? These questions do not have to cross the mind of the employed radiologist.

Finally, if you employ other workers/services, you also rely on their work. If they don’t show up, you don’t get paid!

A Major Independent Contractor Pitfall

For those of you who go down the road of an independent contractor, you must remember what you take home; you do not entirely keep. Naturally, you always have to save additional money for the taxman. More than that, you will also likely need to pay quarterly estimated taxes to prevent IRS penalties. Again, I would talk to your accountant about the details of your situation.

To Be Or Not To Be An Independent Contractor

Becoming an independent contractor as a radiologist certainly can have significant benefits. But, no job comes without its pitfalls as well. Suppose you like the independence of working for multiple groups, getting paid as much as you work and being able to deduct certain work expenses. In that case, independent contracting has a certain allure. At the same time, it also involves different risks you must take. Additional rewards never come without some sacrifice!

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Teleradiology, A Risky Business?

It took years and years of hard work and dedication, long hours and sleepless nights, and the time has finally come.  You’ve got your home office set up, a couple of high resolution monitors, a few licenses and insurance in place.  You’re ready to take that leap of faith and get started in the world of teleradiology, right?

After all, entering the world of teleradiology seems like the dream choice for many radiologists.  Whether you’re working in a small practice by day, hospital at night, or trying to balance work and family, teleradiology can be the ideal choice for your primary income or to supplement your income.

Not so fast.  It’s 2017.  Just two decades ago, healthcare providers didn’t face significant penalties for improperly disclosing protected health information (PHI).  Since then, regulations surrounding the privacy and security of PHI have evolved to include strict requirements and corresponding steep financial penalties for non-compliance.

Where does this leave you? Is it far too risky to give it a try?

With security protocols and policies such as Information Security Risk Analysis, Information Security Risk Management Program, Information Security Audit Controls, System Activity Review Policy, Security Incident Response Policy, Data Backup and Storage Policy, Data Disposal Policy, Media Re-Use Policy, Workstation Policy, and Electronic PHI Movement Policy, is it best to stay out of the game?  You will also have to think about privacy policies such as PHI Uses and Disclosures, Patient Access, Accounting of Disclosures, Sanctions Policy, and Breach Policies and Procedures.  Don’t forget about the Regulations imposed by both federal and state authorities – there’s HIPAA, the Privacy Rule, Security Rule, HITRUST, The Omnibus Rule, Unique Identifiers Rule and the Enforcement Rule just to name a few.

Still ready?  Still have that home office, those high resolution monitors, various licenses and insurance in place?  Great!  Let’s do it!

But how?

My suggestion is, find a teleradiology company that has built a strong Data Security and Compliance Department.  A teleradiology company that has taken the necessary measures to secure Protected Health Information. One that is sought after by the larger urgent care centers, hospitals, and government entities because they have put these measures in place.  Urgent Care acquisitions are at an all time high.  These larger healthcare organizations are driving the teleradiology industry to be more security conscious.  If you want to be successful in this industry you will choose a teleradiology provider that is able to meet the expectations of these larger healthcare organizations.

This will be the teleradiology company that grows, and that contracts with the largest clients.

This will be the teleradiology company that safely and securely helps you realize the dream of becoming a teleradiologist.